Grant Details
Grant Number: |
5R01CA089513-04 Interpret this number |
Primary Investigator: |
Siminoff, Laura |
Organization: |
Case Western Reserve University |
Project Title: |
Family Conflict and Decision Making for Advanced Cancer |
Fiscal Year: |
2004 |
Abstract
DESCRIPTION: Family discordance about treatment decisions can greatly
compromise the quality of life of cancer patients and family caregivers. Family
members often urge advanced cancer patients to accept futile care that can
impair their quality of life. Disputes over treatment decisions further
undermine caregivers' physical and psychosocial well being. This study will
develop a new measure that can validly and reliably assess the likelihood and
degree of family discordance about cancer treatment decisions. The new measure
will be used by physicians to obtain a clinical assessment and researchers to
conduct scientific studies. The creation of this new measure will fill an
existing gap in clinical and health services research.
During the first study year, a series of focus groups will be conducted among
120 advanced lung cancer patients, family caregivers, and health care providers
to identify all aspects of family discordance about treatment decisions. We
will develop a Family Concordance Scale that will contain an initial pool of
scale items and a Family Concordance Semi-Structured Questionnaire to collect
information about family discordance in real life settings. In the first half
of Year 2, the pool of scale items will be piloted among 50 family units,
consisting of 50 advanced lung cancer patients, as well as 50 primary and 50
secondary family caregivers. Revisions will be made accordingly. In a two-year
period, research assistants will conduct two interviews apiece with 250 family
units (750 subjects). In addition, several psychometric instruments that
measure presumptive correlates of family discordance will be administered at
baseline (T1). Following the second interview, a measure that assesses
physicians' estimates of family discordance about treatment decisions will be
completed by oncologists. Chart review will also be conducted to collect
patients' medical and demographic information. The last six months of the study
will be devoted to examining the psychometric and statistical properties of the
scale, especially its validity and reliability.
The final product of this study will be a valid and reliable scale that can be
administered within 10 minutes. Cut-off scores will be provided for classifying
concordant and discordant families. In addition, rich and detailed descriptive
information about the family treatment decision-making process will be
provided.
Publications
None